Cardiac and non-cardiac causes of T-wave inversion in the precordial leads in adult subjects: A Dutch case series and review of the literature

Figure 5 Patient 5. An electrocardiographic (ECG) tracing, showing negative T wave in the precordial leads V_1-3 and S₁ Q₃ T₃, of a 55-year obese male patient without antecedent medical history presented with chest pain and minimally elevated serum cardiac biomarkers. Transthoracic echocardiography revealed dilated and hypokinetic RV with pulmonary hypertension and distended inferior caval vein. Coronary angiography was normal and pulmonary CT angiography confirmed the clinical diagnosis showing massive bilateral pulmonary embolism with central and peripheral localization. A continuous positive airway pressure was implemented for newly detected severe obstructive sleep apnea syndrome. He was successfully treated with medical regimen and on follow-up he became asymptomatic and the abnormal ECG findings gradually disappeared.